The science and side effects of the drugs Ozempic and Wegovy

Ozempic and Wegovy are model names for the drug semaglutide. Many international locations have authorized Wegovy for weight reduction in people who find themselves overweight or chubby and Ozempic for individuals with kind 2 diabetes.

How do these medicine work?

Drugs similar to semaglutide mimic the actions of a hormone referred to as glucagon-like peptide-1, or GLP-1. These so-called GLP-1 analogues have a number of results, together with slowing abdomen emptying, performing on the mind to scale back urge for food and boosting the discharge of insulin, which helps to control blood sugar ranges.

For greater than a decade, GLP-1 analogues have been used to assist individuals with kind 2 diabetes management their blood sugar and a few customers skilled modest weight reduction. “These drugs augment a system that already exists within the human body, whose role it is to suppress appetite following meal ingestion,” says Simon Cork at Imperial College London.

Why are they making headlines now?

GLP-1 analogues have began to be prescribed for weight reduction in individuals with out kind 2 diabetes. They have additionally change into accessible in formulations which might be stronger and simpler to make use of.

Initially GLP-1 analogues have been authorized to be used at a decrease dose and wanted to be given by twice-daily injections. In the most recent formulations they’re once-weekly injections, with Wegovy’s full dose being 2.4 milligrams for weight reduction and Ozempic getting used at a most dose of two milligrams for kind 2 diabetes.

How extensively accessible are they?

In 2021, Wegovy was authorized for weight reduction in a number of international locations, together with the US and Canada. Praise from some celeb customers introduced it widespread publicity.

Manufacturing issues meant its producer, Novo Nordisk, had hassle assembly international demand, so some medical doctors began prescribing Ozempic, which had been authorized for individuals with kind 2 diabetes in sure international locations a number of years earlier. This led to shortages for individuals who required it for diabetes management.

In the UK, Wegovy was authorized in 2021, however solely acquired the nod from England’s medical pointers physique the National Institute for Health and Care Excellence in March 2023, when it mentioned the drug needs to be given by weight reduction clinics throughout the nation’s nationwide well being service. Wegovy is predicted to change into accessible within the UK this 12 months, whereas Ozempic has been accessible for kind 2 diabetes since 2019.

In June 2023, the UK authorities introduced the introduction of a two-year pilot that provides individuals with weight problems entry to new medicine, similar to Wegovy, outdoors of a hospital setting.

How efficient are they?

Very. It is a cliche however weight problems medical doctors are speaking a couple of paradigm shift within the subject of weight problems administration. Previously, a lack of about 5 per cent of physique weight can be thought of an excellent consequence for any weight reduction intervention outdoors of abdomen surgical procedure and is taken into account a benchmark in weight problems drug trials.

Wegovy results in a couple of 15 per cent discount in physique weight over a 12 months, when mixed with train and consuming healthily.

In truth, some individuals appear to really feel that the GLP-1 analogues have induced them to change into too gaunt, as mirrored within the rise of the search phrases “Ozempic face” and “Ozempic butt”. “Ozempic doesn’t do anything specific to the skin,” says Alexander Miras at Ulster University, UK. It is the load loss that causes these obvious unwanted effects, with related outcomes usually additionally occurring after weight reduction surgical procedure, he says.

Do the medicine have any unwanted effects?

Side results could be gentle, similar to nausea, constipation and diarrhoea, which are inclined to happen as individuals get used to the drug. More worrying unwanted effects embody irritation of the pancreas, though that is comparatively uncommon.

How about hair loss?

Hair loss has been reported by some semaglutide customers. This can also be generally seen after vital weight reduction from different causes, similar to abdomen surgical procedure, says Miras.

Hair loss following weight reduction surgical procedure is considered attributable to physiological stress on the physique inflicting an elevated variety of hair follicles to enter their “resting” section, which ends up in the hairs falling out a couple of months later. It stops when the load loss stabilises, nevertheless, the hair doesn’t all the time develop again, says Miras.

Do these medicine trigger suicidal ideas?

GLP-1 analogues – similar to Ozempic and Wegovy – are being investigated by the European Medicines Agency (EMA) after latest studies that they might trigger ideas of suicide or self-harm. This was after Iceland’s well being regulator obtained three such studies concerning semaglutide and one other drug referred to as liraglutide, which is an earlier GLP-1 analogue.

The EMA says it’s analysing about 150 studies of attainable instances of self-injury and suicidal ideas. This doesn’t imply the medicines induced these results, nevertheless, solely that individuals reported these experiences after beginning to take them. “More work is needed to determine if a causal link exists,” says Michael Schwartz on the University of Washington in Seattle.

A spokesperson at Novo Nordisk, the producer of liraglutide and the semaglutide medicine Ozempic and Wegovy, informed New Scientist: “GLP-1 receptor agonists have been used to treat type 2 diabetes for more than 15 years and for treatment of obesity for eight years. The safety data collected from large clinical trial programmes and post marketing surveillance have not demonstrated a causal association between semaglutide or liraglutide and suicidal and self-harming thoughts.”

Need a listening ear? UK Samaritans: 116123; US 988 Suicide & Crisis Lifeline: 988; hotlines in different international locations.

Do these medicine assist with addictions?

Perhaps. There have been many anecdotal studies of individuals taking these medicines for diabetes or weight management who lose their urge to drink alcohol or see waning of different habits that may very well be described as “behavioural addictions”, similar to compulsive purchasing.

This is supported by analysis in animals that discovered the GLP-1 analogues decrease consumption of alcohol and addictive medicine. A small trial in individuals has hinted at an analogous impact from a GLP-1 analogue referred to as exenatide, which lowered heavy consuming, however solely in individuals who have been overweight.

The rationalization may very well be related with the best way the medicine act on the mind to scale back meals cravings, however the actual mechanism is unclear. We are solely in the beginning of understanding how these remedies might help individuals with alcohol and drug additions, says Daniel Drucker at Sinai Health in Toronto, Canada. “The clinical trial data is not yet in to substantiate the anecdotes.”

What occurs to a person’s weight long-term?

The longest trial of Wegovy lasted two years and located that individuals’s weight broadly plateaued within the second 12 months.

In most international locations, Wegovy has been authorized for 2 years’ use, but when individuals cease taking the drug, they typically regain the misplaced weight – two-thirds of it after one 12 months, in keeping with one trial.

“The weight loss is only sustained for as long as the drug is taken because as soon as you stop the drug, all of those physiological processes that are trying to get your body weight back up kick in again,” says Cork.

This means that after two years of use, there will likely be demand from shoppers for medical doctors to proceed prescribing the drug “off label”. “I think there’ll be a big push to try to change those guidelines,” says Cork.

Ozempic could be prescribed long-term for kind 2 diabetes as a result of the situation is often life-long.

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